Provider Demographics
NPI:1134296411
Name:UNGER, ISADORE ALLAN (LCSW ACSW)
Entity Type:Individual
Prefix:MR
First Name:ISADORE
Middle Name:ALLAN
Last Name:UNGER
Suffix:
Gender:M
Credentials:LCSW ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5020
Mailing Address - Country:US
Mailing Address - Phone:914-631-2931
Mailing Address - Fax:914-923-5790
Practice Address - Street 1:66 SPRING ST
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-5020
Practice Address - Country:US
Practice Address - Phone:914-631-2931
Practice Address - Fax:914-923-5790
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR23691-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN2K541Medicare ID - Type Unspecified